Month: April 2017

One of the last substantial barriers to increasing the number of euthanasia cases for non-terminally-ill psychiatric patients in Belgium seems to have crumbled. A religious order in the Catholic Church, the Brothers of Charity, is responsible for a large proportion of beds for psychiatric patients in Belgium – about 5,000 of them. The international head of the order, Brother René Stockman, is a Belgian who has been one of the leading opponents of euthanasia in recent years. Nonetheless, in a surprise move this week, the board controlling the institutions of the Brothers of Charity announced that from now on, it will allow euthanasia to take place in their psychiatric hospitals. . . . Full Text

Butter Braco

A Christian midwife is appealing her case to the European Court of Human Rights (ECHR) after she was denied employment opportunities due to her views regarding abortion.

The Alliance Defending Freedom (ADF) is supporting Ellinor Grimmark of Sweden, arguing that various places of employment infringed on her freedom of conscience in their refusal to hire her due to her views on abortion.

In November 2013, a job offer Grimmark received from a women’s clinic was withdrawn after it became known that she opposed abortion. A similar scenario occurred in 2014.

Grimmark took her case to court in 2015, but the District Court of Jönköping ruled that freedom of conscience could only be invoked when a person is not religious. . . [Full text]

‘We all want to die with dignity,’ says palliative care director

Danny Kerslake

For about a year, it has been legal to die with medical assistance in Canada. Almost two dozen people in this province have chosen that option and ended their lives.

“We all want to die with dignity,” said Carmen Johnson, medical director of Palliative Care at Pasqua Hospital in Regina.

According to numbers obtained by CBC, as of the end of March, 21 people in Saskatchewan have died with medical assistance since the federal government’s assisted-dying law passed last June. . . [Full text]

Swedish midwife Ellinor Grimmark has decided to appeal to the European Court of Human Rights over Sweden’s hard line on conscientious objection. The Swedish Appeals Court decided earlier this month that the government can force medical professionals to perform and cooperate in abortions, or else be forced out of their profession. Because the ruling in Grimmark v. Landstinget i Jönköpings Län appears to contradict international law protecting conscientious objection, Grimmark wants to appeal to Strasbourg. . . .Full Text

Lynn Wardle

As more nations and states legalize medical assistance in dying (herein “MAID”), more cases are being reported of coercive and abusive pressures being used to force doctors who object to performing, assisting or making referrals for physician-assisted suicide to engage in complicit behavior.

In 2016 it was reported that euthanasia or assisted suicide was legal in only eight nations (Belgium, Canada, Colombia, Germany, Japan, Luxembourg, Netherlands, and Switzerland) and in only six American states (California, Colorado, Montana, Oregon, Vermont, and Washington – plus also in the District of Columbia). That amounts to less than four percent of the sovereign nations in the world, and just twelve percent of American states.

Thus, the total number of jurisdictions that allow MAID is actually very small. The acceptance of MAID globally and in the U.S. has been rather under-whelming – especially since efforts to legalize such practices have been urged for many decades.

The miniscule portion of jurisdictions that have legalized MAID is all the more striking when contrasted with the decades of relentless efforts to legalize such practices. Yet the profound moral dilemmas that MAID creates are of great significance.

Yet the experience of nations where MAID is legal is very troubling. Some advocates of MAID cannot abide having any doctors who will not perform or support such killings, so they pressure those who disagree with them to comply and conform. They seem to view the mere existence of differing views in their medical community to be a threat that must be eliminated.

Because of such dynamics, there really is no “middle ground” on the issue of legalizing MAID. Either a health care provider supports the “progressive” policy of MAID, or he/she is viewed and treated as a real or potential threat – to be marginalized, opposed, and excluded from professional influence.

Sadly, such “progressive” hostility to conscientious objection harms communities and the individual and family members of communities. It deprives them of a safety-net that keeps the medical system and the medical establishment honest.

“Free conscientious objection to MAID” [Medical Assistance in Dying], wrote Assistant Professor Christine Cserti-Gazdewich, “reveals flaws and coaxes improvements. This constructive dialogue is … the vitality of a system striving for excellence.” Without such protections as for rights of conscience she predicted “quantitative and qualitative corrosion of our health care workforce.”

Such checks and balances are especially important now, as medical decisions and medical professionals are playing an increasing – and increasingly important – role in the lives of more and more citizens. Loss of the protection of conscientious objection marginalizes and endangers the significant (if small) community of medical professionals who have and try to live by the values of their religious faiths.

For example, Sean Murphy of Canada reports that: “Attacks on physician freedom of conscience in the Canadian province of Ontario have become acute since the legalization of euthanasia and physician assisted suicide in 2016. Doctors have been threatened with discipline or dismissal if they refuse to comply.”

For some persons of faith, the act of referring a patient to a professional who will aid them to commit suicide or voluntary self-euthanasia is an act of complicity in a severe moral evil. While others may not agree with those moral principles, all of us can and should respect those who hold those views and should protect their right to try to live by them.

MAID is a relative recent phenomenon in North America. In 2015, the Supreme Court of Canada ruled unanimously in Carter v. Canada that the Canadian Charter of Rights and Freedoms required the government to allow MAID for “a competent adult person who (1) clearly consents to the termination of life; and (2) has a grievous and irremediable medical condition (including an illness, disease or disability) that causes enduring suffering that is intolerable to the individual in the circumstances of his or her condition.”

In June 2016 Canada enacted a law (Bill C-14, the Medicial Assistance in Dying Act) that allowed MAID for adults suffering from terminal physical illnesses whose natural death is “reasonable foreseeable.” Ironically, the most vigorous opposition to the Canadian MAID legislation was not from conservatives opposed to legalizing assisted suicide or euthanasia but from liberals who wanted MAID to be available to minors and to persons suffering from non-physical illnesses and to persons whose death was not imminent.

Canada has had less than a year’s experience with MAID. Yet, already some Canadian doctors have left the profession to avoid being forced to refer persons for euthanasia.

Coalition for HealthCARE and Conscience has been formed to support physicians who oppose being forced to perform or refer patients to doctors who perform medical assistance in dying (assisted suicide). Likewise, Canadian Physicians for Life is another organization of medical professionals to oppose mandatory MAID.

Such organizations are not just commendable but essential. If the experience of medical abuses in Nazi Germany showed nothing else, they showed that institutional pressures to facilitate killing the unwanted and the vulnerable eventually corrupt professional organizations that were formed to protect the weak and to provide healing services to the ill and injured. So the creation of institutions willing to blow the whistle about such abuses is critical to protect rights of conscience.

The failure of the Canadian government to create serious institutional checks and protections and the lack of agencies and officials clearly charged to protect and given adequate resources to prevent and punish abuses are revealing. Merely mouthing platitudes about respect for rights of conscience without real institutional means and without systemic commitment to do so virtually guarantees neglect of the rights of the minority who oppose killing within the profession and nation.

Lynn D. Wardle is the Bruce C. Hafen Professor of Law at Brigham Young University. He is author or editor of numerous books and law review articles mostly about family, biomedical ethics and conflict of laws policy issues. His publications present only his personal (not institutional) views.

Heather Clark

SAN FRANCISCO, Calif. — A California woman who identifies as a man has filed a lawsuit against a Catholic hospital and its parent company for prohibiting her surgeon from performing a sex change-related hysterectomy at the facility because of the organization’s religious convictions.

The 35-year-old woman, who goes by the name Evan Minton, had been scheduled to undergo a complete hysterectomy at Mercy San Juan Medical Center in Carmichael last August. She believed the procedure was necessary to comport with her preferred identity.

However, the day before her appointment, after she noted to a nurse that she identifies as “transgender,” the surgery was canceled.

“In general, it is our practice not to provide sterilization services at Dignity Health’s Catholic facilities,” said spokeswoman Melissa Jue in a statement at the time. . . [Full text]

Perry Chiaramonte

The Swedish midwife who lost her legal battle to be exempt from assisting in abortions—an act she has said violates her religious freedom—has decided to push her case to the European Court of Human Rights even though she likely will not return to Sweden.

“In the beginning, I was hoping to stay in Sweden,” Grimmark said in a phone interview with Fox News from her new home in Norway, where she moved two and a half years ago after she was let go from three different hospitals in Sweden. “But we have now made Norway home. I have a job here where they are not concerned with my beliefs.” . . . [Full text]

Morten Magelssen

Abstract

By way of a case story, two common presuppositions in the academic debate on conscientious objection in healthcare are challenged. First, the debate typically presupposes a sharp division between conscience-based refusals based on personal core moral beliefs and refusals based on professional (eg, medical) reasons. Only the former might involve the moral gravity to warrant accommodation. The case story challenges this division, and it is argued that just as much might sometimes be at stake morally in refusals based on professional reasons. The objector’s moral integrity might be equally threatened in objections based on professional reasons as in objections based on personal beliefs. Second, the literature on conscientious objection typically presupposes that conflicts of conscience pertain to well-circumscribed and typical situations which can be identified as controversial without attention to individualising features of the concrete situation. However, the case shows that conflicts of conscience can sometimes be more particular, born from concrete features of the actual situation, and difficult, if not impossible, to predict before they arise. Guidelines should be updated to address such ‘situation-based’ conscientious refusals explicitly.

Ruth Gledhill

A leading Christian nurse is warning that nurses and midwives could find themselves under new pressures to be involved with abortions and other procedures that go against their conscience.

Steve Fouch, head of nursing with the the Christian Medical Fellowship Head of Nursing, warns in a blog of a challenge to the rules that allow doctors to opt out of abortions.

He is writing after a new study, headlined ‘Vacuum aspiration for induced abortion could be safely and legally performed by nurses and midwives’, questions the need for abortions to be carried out by doctors in the first place. . . [Full text]